Abstract
Female genital mutilation (FGM) is defined as an injury of the external female genitalia for cultural or non-therapeutic reasons. FGM is mainly performed in sub-Saharan and Eastern Africa. The western health care systems are confronted with migrants from this cultural background. The aim is to offer information on how to approach this subject. The degree of FGM can vary from excision of the prepuce and clitoris to infibulation. Infections, urinary retention, pain, lesions of neighbouring organs, bleeding, psychological trauma and even death are possible acute complications. The different long-term complications include the risk of reduced fertility and difficulties during labour, which are key arguments against FGM in the migrant community. Paediatricians often have questions on how to approach the subject. With an open, neutral approach and basic knowledge, discussions with parents are constructive. Talking about the newborn, delivery or traditions may be a good starting point. Once they feel accepted, they speak surprisingly openly. FGM is performed out of love for their daughters. We have to be aware of their arguments and fears, but we should also stress the parents’ responsibility in taking a health risk for their daughters. It is important to know the family’s opinion on FGM. Some may need support, especially against community pressure. As FGM is often performed on newborns or at 4–9 years of age, paediatricians should have an active role in the prevention of FGM, especially as they have repeated close contact with those concerned and medical consequences are the main arguments against FGM.
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Abbreviations
- FGM:
-
Female genital mutilation
- WHO:
-
World Health Organization
References
Almroth L, Bedri H, Elmusharaf S, Satti A, Idris T, Hashim MS, Suliman GI, Bergström S (2005) Urogenital complications among girls with genital mutilation: a hospital-based study in Khartoum. Afr J Reprod Health 9:118–124
Almroth L, Elmusharaf S, El Hadi N, Obeid A, El Sheikh M, Elfadil S, Bergström S (2005) Primary infertility after genital mutilation in girlhood in Sudan: a case-control study. Lancet 366:385–391
Elmusharaf S, Elhadi N, Almroth L (2006) Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study. BMJ 333:124–127
Hohlfeld P, Thierfelder C, Jäger F; For the working group FGM (2005) Swiss Guidelines: Patientinnen mit genitaler Beschneidung. Schweizerische Empfehlungen für Ärztinnen und Ärzte, Hebammen und Pflegepersonal. Schweiz Aerztezeitung 86(16):951–960
Jäger F, Schulze S, Hohlfeld P (2002) Female genital mutilation in Switzerland: a survey among gynaecologists. Swiss Med Wkly 132:259–264
Johansen REB (2006) Care for infibulated women giving birth in Norway: an anthropological analysis of health workers’ management of a medically and culturally unfamiliar issue. Med Anthropol Q 20:516–544
Leye E, Deblonde J (2004) Législation Européenne relative aux Mutilations Génitales Féminines et application de la loi en Belgique, en France, en Espagne, en Suède et au Royaume-Uni. International Centre for Reproductive Health, Gand, Belgium
Leye E, Powell RA, Nienhuis G, Claeys P, Temmerman M (2006) Health care in Europe for women with genital mutilation. Health are Women Int 27:362–378
Low N, Marti C, Egger M (2005) Mädchenbeschneidung in der Schweiz: Umfrage von UNICEF Schweiz und der Universität Bern. Schweiz Aerztezeitung 86:970–973
Macready N (1996) Female genital mutilation outlawed in United States. BJM 313:1103
Pok Lundquist J, Haller U (2001) Aspekte der rituellen “Frauenbeschneidung.” Gynäkol Praxis 25:321–328
Snow RC, Slanger TE, Okonofua FE, Oronsaye F, Wacker J (2002) Female genital cutting in southern urban and peri-urban Nigeria: self-reported validity, social determinants and secular decline. Trop Med Int Health 7:91–100
Terre des Femmes Suisse (2006) Nous protégeons nos filles, informations sur l’excision pour pères et mères, brochure d’information. Home page at: http://www.terre-des-femmes.ch
The Department of Health, UK (2004) CMO Update 37: February. Available online at: http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/CMOupdate/DH_4070172
Thierfelder C, Tanner M, Bodiang CM (2005) Female genital mutilation in the context of migration: experience of African women with the Swiss health care system. Eur J Public Health 15:86–90
Trechsel S, Schlauri R (2004) Weibliche Genitalverstümmelung in der Schweiz, Rechtsgutachten, UNICEF. Available online at: http://assets.unicef.ch/downloads/UNI_Rechtsgutachten_WGV_de.pdf
Turillazzi E, Fineschi A (2007) Female genital mutilation: the ethical impact of the new Italian law. J Med Ethics 33:98–101
UNICEF, Al-Azhar University (2005) Children in Islam: their care, upbringing and protection. UNICEF, Al-Azhar University, New York, pp 61–62
WHO Study Group on FGM (2006) Female genital mutilation and obstetric outcome: WHO collaborative prospective study in six African countries. Lancet 367:1835–1841
World Health Organization (1997) Female genital mutilation: a joint WHO//UNICEF/UNFPA statement. WHO, Geneva. Available online at: http://www.who.int/reproductive-health/publications/fgm/fgm_statement.html
World Health Organization (2001) Female genital mutilation and harmful traditional practices. Progress report. WHO, Geneva
World Health Organization (1998) Female genital mutilation: an overview. WHO, Geneva
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Jaeger, F., Caflisch, M. & Hohlfeld, P. Female genital mutilation and its prevention: a challenge for paediatricians. Eur J Pediatr 168, 27–33 (2009). https://doi.org/10.1007/s00431-008-0702-5
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DOI: https://doi.org/10.1007/s00431-008-0702-5